A client is scheduled for an abdominal ultrasound in two weeks to assess fetal growth and development during pregnancy.

Which of these statements made by the client indicates that further teaching is needed?

This is because cramping and vaginal bleeding after an amniocentesis may indicate a possible miscarriage or placental abruption, which can compromise fetal oxygenation and perfusion.

Monitoring fetal heart rate can help detect signs of fetal distress and guide further interventions.

Choice A is wrong because administering Rho(D) immune globulin is indicated for Rh-negative mothers who undergo amniocentesis to prevent isoimmunization, but it is not a priority action in this scenario.

Choice C is wrong because assessing maternal vital signs is important to monitor for signs of infection, hemorrhage, or shock, but it is not as urgent as monitoring fetal well-being.

Choice D is wrong because obtaining an order for an ultrasound exam can help confirm the diagnosis and evaluate the placenta and amniotic fluid, but it is not the first action to take in this situation.

"It is a screening test for spinal defects in the fetus."

The MSAFP test is a blood test that measures the amount of alpha-fetoprotein (AFP) in the mother’s blood.

AFP is a protein produced by the baby during pregnancy.The test helps to assess the baby’s risk of certain birth defects, such as neural tube defects, which are abnormalities in the development of the brain and spine.

A. “It is a diagnostic test for spinal defects in the fetus.” This statement is wrong because the MSAFP test is not a diagnostic test.

It only indicates the probability of having a spinal defect, but it does not confirm or rule out the condition.A diagnostic test, such as an ultrasound or amniocentesis, is needed to make a definitive diagnosis.

C. “It is a diagnostic test for chromosomal abnormalities in the fetus.” This statement is wrong because the MSAFP test is not a diagnostic test for chromosomal abnormalities either.

It only indicates the probability of having a chromosomal abnormality, such as Down syndrome, but it does not confirm or rule out the condition.A diagnostic test, such as a chorionic villus sampling (CVS) or amniocentesis, is needed to make a definitive diagnosis.

D. “It is a screening test for chromosomal abnormalities in the fetus.” This statement is partially correct, but not the best answer.

The MSAFP test alone is not very accurate for screening chromosomal abnormalities.It is usually combined with other blood tests and an ultrasound to form a more reliable screening test called a quad screen or an integrated screen.

The normal range of MSAFP levels varies depending on the gestational age of the baby and the laboratory methods used.Generally, the MSAFP levels increase until about 15 weeks of pregnancy and then decrease until delivery.The average MSAFP level at 15 weeks of pregnancy is about 38 ng/mL.However, different laboratories may have different reference ranges, so it is important to consult your healthcare provider for your specific results and interpretation.